Why Don’t more Firefighters have PTSD?

Just mentioning the words Post Traumatic Stress Disorder or PTSD probably has you running for the hills right now but trust me, it doesn’t have to be a scary subject. Every firefighter in this world is willing to take on any risk to save another person’s life. Sometimes that risk means witnessing or engaging in a crisis that would be unthinkable for the average Joe on the street to handle. You jump in on someone’s worst day of his or her life and at times risk your life for the sake of theirs. With that said, sad to say it, but that means you have witnessed a traumatic event. When you witness a traumatic event, it puts you at risk for developing PTSD. It puts you at greater risk to develop PTSD when you continuously witness traumatic events. It probably sounds a lot like your day-to-day life as a firefighter, endlessly witnessing trauma.

There is such limited information out there to let you know what the stats say about PTSD amongst firefighters. The most consistent, predicted number out there says that about 37% of firefighters show signs or symptoms of PTSD. You would think that number would be higher since it is pretty safe to say that 100% of you witness at least one traumatic event throughout the course of your career. You’re probably laughing right now because that number is probably way higher than one.

Whether it was by choice or by chance, the way that a firehouse is set up, and the way that your schedule works is a protective factor that reduces your risk to develop PTSD. Protective factors are a fancy way of saying that there is something in place that helps you reduce the risk of developing PTSD. Psychologists, actually let’s call them head docs; they had to develop a fancy way to say it that sounded smart. It looks better in our field when we sound smart.

So let’s look at what these protective factors are and how you can rely on them to process through any traumatic event that you might come across. Because let’s face it, the next alarm that goes off could lead you right into someone’s worst day and your next call might be the one that is hard to forget. Your next call might be the one that plays over and over in your mind. Your next call might be the one that wakes you up at night in a pool of sweat. You never know what the next call is.

So what about these protective factors makes the risk of PTSD lower for firefighters? The fact that you live in the firehouse with the same people that are going through the same trauma with you, that in itself allows you to process events in a healthy way. You are side by side with the same people day in and day out, and they are someone with whom you can relate. You eat, sleep, shower, and who knows what else goes on in there but regardless, you do this with one another. If you were to experience an incident and then immediately return home to your family, it would make it harder to process it fully and effectively because they didn’t live the incident with you. The other protective factor is your schedule, as much as your wife, girlfriend, partner, might hate your schedule, it is a protective factor. When you work these long hours, it means that your support system is right there with you and that helps.

I know many of you think that you are invincible but even though you aren’t the average Joe, you still breathe and bleed just as they do. So just because these protective factors are in place, doesn’t mean you are invincible to developing PTSD. You should know the warning signs and talk to someone about it. Really quick. Here are some down and dirty signs to look for: If you are experiencing panic attacks, feeling numb towards emotions, difficulty concentrating, frequent nightmares, feeling extra stress or anxiousness, flashbacks to the event that feel real, or even memory loss, you might need to find someone to talk to about it. These are just some quick signs that should trigger you to dig a little deeper and see if everything is alright.

So turning to someone for help doesn’t mean you are weak, it means you are human. If you think things don’t feel right, you should listen to your body and talk to someone. At the end of the day, the world needs you and needs you to take care of yourself.

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Ashley is a National Certified Counselor. She holds a Bachelor of Science in Social Work, a Masters of Science in Marital and Family Therapy, and a Masters of Science in Nonprofit Management and Philanthropy. Ashley has respectable experience working with trauma therapy, recovery, rehabilitation, co-occurring disorders, crisis support, crisis intervention and crisis response. Ashley comes from a Firefighter family in Iowa and possesses intimate exposure to the world of firefighting. She currently lives in Connecticut where she works for a non-profit agency assisting families and as a Mental Health Clinician. Ashley has a passion for restoring antique furniture and curling up on the couch with her dog Bailey.

27 Comments on Why Don’t more Firefighters have PTSD?

Who said they don’t. To understand PTSD you need to be exposed to it. Do you think for one moment cities will deal with a FF PTSD and assume the expense? I’m a Viet Nam vet. Spend 2 year in Nam and the smells of that period have permanently invaded my senses. I spend 30 years as a FF and many of the smells set me of. Many of the experiences made me cry so hard I ran out of tears.
I tear up right now just thinking about it. I used anger to mask my hurt during my time in the department and alcohol when not on duty.
For 32 + years I had no place to turn nor did I understand what was going on in my head.
I have a great wife that helped me on so many occasions to cope. I will for ever thank for that.

Firefighter PTSD is through the roof. We just cover it up very well. Being in a firehouse can actually be a bad thing because no one wants to admit they have a problem with a call. I can safely say 100% of FFs suffer from PTSD and the majority will not admit it or don’t know they have it. It starts off small like a leak in a dam and the next thing you know you are sitting in a room by yourself with a bottle of Jack and a gun. Think I’m joking? Ask any FF if he knows someone who has committed suicide. If they don’t then they are new to the Profession.

I’ve spent a career in the military and am a firefighter as well. Obviously both are exposed to high stress situations and have similar recovery mechanisms. A huge difference is people in the military take lives and often get to deal with the end results. Firefighters risk much also but their function is to save lives.

Why? I will presume then from your statement that you know how the neurological stress response works, how the body releases said energy, and how firefighters are taught about this system and how to release that energy. That PTSD, secondary trauma, and how we react to them are part and parcel of the fire fighter culture.

Considering the NFPA can’t even admit how many firefighters committed suicide last year, and the ignorance I mentioned above, I think that the unwillingness to face the above issues is manifest. I won’t say 100% have PTSD, but the numbers are higher than reported, which is rolling in at 30-40%, despite the fact we’ve had pretty much the same tool box for these issues for 30 years. Those are high numbers. As Firefighter Behavioral Health Alliance has confirmed, 117 of us killed themselves last year. Fifty two so far this year. That’s our biggest health issue, and almost completely unacknowledged.

And almost completely avoidable. I healed my PTSD, because I used a tool (second phrase, second sentence) that wasn’t in our toolbox.

The article was geared toward fulltime firefighters. Those of us who are volunteers don’t have ways to deal with things the way fulltimers do. Although are job is to save lives it is harder to loose a patient. The kids are the worse. There are some calls that still haunt me years after the trucks were parked and my turnouts hung up. I can still see the lifeless blue eyes of 21yo pregnant girl killed by a drunk driver newyears eve 2006. The family that was mostly wiped out on an interstate highway bridge. The 16yo killed in an atv rollover. There are some saves and good out comes, but those are out numbered by the bad ones. I also served in the military. Luckily I did not have to take a life and deal with all that comes with it. I have to think that doing everything possible to save a life only to loose must have some of the same things. I only know the one side. Will this keep from jumping when the tones go off. Hell no! I am learning that dealing with the emotions and feelings is better than hiding them. My heavybag helps along with a couple of close friends to talk to and cry if I need to. As much as it pains to admit I have shed some tears after a call. No matter what happens after a call is over. As long as we try to help each other we can get through it. After loosing my little brother (who was a city chief) to a heart attack after a fire. It was the firefamily that helped us through it. Do I suffer from PTSD I don’t know. All I do know is yes some calls affect me, but so far none have kept me from working or continuing to serve my family and country.
Thank you to all who have served and to those still serving.

I am sorry to hear that it pains you to admit you cry after calls. That’s the perfectly, normal, human response. I always thought I was okay because I could still respond. Turns out I was wrong. Turns out my high blood pressure was stress induced. Turns out the cancerous mole on my back was stress induced. Turns out I had PTSD. Still going to shifts (even as a volunteer), responding to calls.

The article was geared toward fulltime firefighters. Those of us who are volunteers don’t have ways to deal with things the way fulltimers do. Although are job is to save lives it is harder to loose a patient. The kids are the worse. There are some calls that still haunt me years after the trucks were parked and my turnouts hung up. I can still see the lifeless blue eyes of 21yo pregnant girl killed by a drunk driver newyears eve 2006. The family that was mostly wiped out on an interstate highway bridge. The 16yo killed in an atv rollover. There are some saves and good out comes, but those are out numbered by the bad ones. I also served in the military. Luckily I did not have to take a life and deal with all that comes with it. I have to think that doing everything possible to save a life only to loose must have some of the same things. I only know the one side. Will this keep from jumping when the tones go off. Hell no! I am learning that dealing with the emotions and feelings is better than hiding them. My heavybag helps along with a couple of close friends to talk to and cry if I need to. As much as it pains to admit I have shed some tears after a call. No matter what happens after a call is over. As long as we try to help each other we can get through it. After loosing my little brother (who was a city chief) to a heart attack after a fire. It was the firefamily that helped us through it. Do I suffer from PTSD I don’t know. All I do know is yes some calls affect me, but so far none have kept me from working or continuing to serve my family and country.
Thank you to all who have served and to those still serving.

Ms. Brehm: Thanks for this – you have touched on what I feel are some very important aspects of PTSD. (And also pointed out some decided advantages that firefighters have – specifically, the environment in which most of them work [“unified teams”, “family”] & that most [“on-duty”, “career”] have the opportunity during & after such calls to discuss both the details of the incident & their reaction to same. As some commenters have already pointed out, not all FD’s encourage / abet that sort of informal CISD, but those that do I believe are doing their firefighters – and the communities they serve – a great service.) I hope you will continue to write – whether ’bout firefighting (and firefighters) or the rest of the universe. Hugs to you & your “Firefighter family in Iowa.” MP.

Good article, from the opinion of a 30 year fire service veteran, who is suffering from PTSD. I was nearly killed in the line of duty 18 months ago and my firefighter’s saved my life (Google me for my sorry, if you’d like).

You mention firefighter (physical) fitness and half your department freaks out. No one, or very few firefighters ever talk about mental fitness/wellness. Our peers, our administrators, or our budget folks may ostracize those who show signs, symptoms of express concerns about PTSD. We are viewed as weak, or an expensive potential workers comp concern.

Firefighter suicide rates are exploding!

This all needs to change!! The brotherhood (and sisterhood) needs to support those struggling in their departments. PTSD should be no different than a broken leg – no secrets and gossip; this just makes the PTSD victim feel worse.

For me, every day is a challenge. Thoughts of suicide occur regularly, although I don’t think it is a true and/or viable option. I am on meds and in counseling and it is helping. Additionally, I find familial support, my dog, extreme exercise, giving back and Mother Nature, are essential for an expeditited recovery.

Because we are invincible just look at me! Well I was for 24 yrs until I got a career ending injury that caused all kinds of bad stuff to flow out of me to the point after a suicide attempt the dr and nurses and clinical persons could not believe how graphically detailed I was able to describe the events coming out. AND municipalities do not want to admit to the liability of workmans comp associated with PTSD. There are more then we realize because WE DO NOT TALK OR REPORT IT!

Wake up brothers and sisters, WE ARE NOT INVICIBLE, we are human with emotions that we hide pretty good.

Interesting article, but a lot of assumptions there. No offense. It is unfortunate that she is close physically but has not “been there”. There is no “right” way for PTSD to come out, and you can’t predict when and where you will START to think you may have an issue. Everyone is different. Our family, friends and coworkers (cops, ambulance folks, hospital friends) will see it long before…but they will think your having an off day. Paid doesn’t have a corner on the market here, we ALL see bad shit and we all need to know it leaves a mark. How will you know you have an issue….you wont, but listen for someone to ask “what’s wrong with you? Then start to think seriously about finding a good counseler. My advice keep it orivate, always! Pay cash and no one, but no one hears what happens behind that door. If they care that be ok, if they pry, walk away. You can’t be healed back to the way you were, but you can put it on the shelf and soldier on. Los Angeles County Fire, 31 years…Army Air Cavalry 7 years.

“you can soldier on” “private behind closed doors”. You go with that and become one of the 21+ vets that take their lives every day. There is no such thing as private behind closed doors. The counselor which the city send me to gave a complete report to HR each and every time.
However, I am glad that it worked for you

In my estimation we do to a certain extent but we learned how to deal with it. We did more destressing at the kitchen table with our crew and a cup of coffee after a bad incident. We had more of a issue with outsiders coming in telling us that we had an issue. I myself had more of a problem with nightmares after I was injured breaking my neck and back and reliving the moment of my injury than any bad call. Great article.

On Dec 20, 2015 6:19 AM, “Station Pride” wrote: > > Tommy Anderson commented: “In my estimation we do to a certain extent but we learned how to deal with it. We did more destressing at the kitchen table with our crew and a cup of coffee after a bad incident. We had more of a issue with outsiders coming in telling us that we had a” >

I had a nagging call with the death of a child due to the time of year and before the birth of my daughter. They continue 21 years later. BUT all hell came back for me when I was hurt and then forced out. I understand where your coming from completely!

The de-stressing at the kitchen table is very much like the WWII soldiers returning to the US after the war. They went out together and the ones that survived came home together as a unit. They formed a bond and friendship sealed with blood and guts. Upon their return, they had weeks at a times on the ship to talk about things and occurrences. They relived and allowed the occasion to diminish to a degree and made the atrocities palatable in some ways. In many instances it removed the scares of the events, but there will always be a stain to remind them of what happened. The veterans since did not have that luxury, they went to war by them self and formed a unit at the operational theater and return by them self. Some were lucky and were received by wonderful people welcoming them home at the airports and would express a moment of appreciation. The one for certain, their experiences changed them, it took their innocence and so they no longer fit in were they once lived.
Than they join the fire department and fail to make friends. Their war experience does not allow them to, they don’t want to lose any more friends

I married a retired FF who had also served in Viet Nam. I really had no idea of what he had gone through and how much of it has stayed with him many years later. He deals with anger issued, sleep disorders and numerous problems that just don’t seem to go away. After throwing himself out of bed into a wall (breaking his neck) – he was back in Viet Nam – he sought help and both therapy and medication have made a big positive difference. We who have had calm lives with little chaos or danger have no idea how great the problems can be.